Background: Nearly 1.6% of all births in Germany begin in an out-of-hospital setting. About 5% of these women had a prior cesarean section.
Aim: This study explored the decision-making process of parents choosing the out-of-hospital setting for their next birth.
Method: 10 couples were interviewed. All women had a prior cesarean section and started their next birth in an out-of-hospital setting. The mothers and fathers were interviewed separately. Structured content analysis was used to analyse the 20 interviews.
Results: Some women considered an out-of-hospital setting for their first birth, but chose the hospital because of safety concerns of their partners, or for medical reasons. The negative experience they had while giving birth in the hospital influenced the parents' decision to choose an out-of-hospital setting for their next birth. The decision about the birthplace was negotiated between the partners and with the advice of supportive health care pro-viders. Often, relatives, friends and neighbors were neither involved nor informed.
Conclusion: Empathic and sensitive behavior of the clinical health care provider has an influence on the birth experience. Professional and self-reflective behavior supports the well-being of the parents. There seems to be a correlation between the intimately held decision about place of birth and the lack of acceptance of out-of-hospital birth in society.